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Providence Orthodontics Dhillon PLLC

Dentist, Orthodontics and Dentofacial Orthopedics in Las Vegas, NV. Organization (NPI-2).

NPI number1124568043
StatusActive
Last updated in NPPESFeb 20, 2023

Details

NPI
1124568043
Entity type
Organization (NPI-2)
Legal business name
Providence Orthodontics Dhillon PLLC
Organization subpart
No
Enumeration date
Feb 24, 2017
Certification date
Feb 20, 2023
Last updated
Feb 20, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223X0400X Dentist, Orthodontics and Dentofacial OrthopedicsS681NVYes

Other names

  • Edge Dental & Orthodontics (Doing Business As)
  • West Henderson Dental & Orthodontics (Doing Business As)
  • Buffalo 215 Dental & Orthodontics (Doing Business As)

Practice location

7181 N Hualapai Way
105
Las Vegas, NV 89166-1115

Phone 702-852-1818 · Fax 702-947-5088

Mailing address

7181 N Hualapai Way
105
Las Vegas, NV 89166-1115

Phone 702-852-1818 · Fax 702-947-5088

Authorized official

Tiffany Lorick
Credentialing Specialist
7048063632

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